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Updated: Jun 25, 2026
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Single Port Donor Nephrectomy
Published on: March 12, 2011
Strategic hand assistance for effective and safe retroperitoneoscopic live donor nephrectomy
1Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Tochigi, Japan. yashima@luke.or.jp
Transplantation Proceedings
|March 3, 2009
Summary
This study introduces a modified hand-assisted retroperitoneoscopic live donor nephrectomy technique. The method improved surgical outcomes, reducing warm ischemia time and blood loss without affecting graft function.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Transplantation Surgery
Background:
- Hand-assisted laparoscopic live donor nephrectomy is a common procedure.
- It allows for safe dissection of renal vessels and reduces warm ischemia time (WIT).
- Pure retroperitoneoscopic techniques can present challenges with limited working space.
Purpose of the Study:
- To describe and evaluate an original method of hand assistance in retroperitoneoscopic live donor nephrectomy.
- To assess the safety and efficacy of this modified surgical approach.
Main Methods:
- A hybrid technique involving initial pure retroperitoneoscopic mobilization followed by hand-port placement.
- Ureter dissection was completed openly, while renal vessels were dissected and transected using hand-assisted retroperitoneoscopy.
- The kidney was extracted through the hand port.
Main Results:
- 66 procedures were performed (14 right, 52 left) with acceptable technical and functional outcomes.
- Mean operative time: 246 min, WIT: 209 sec, blood loss: 202 mL, renal vein length: 17.4 mm.
- Comparison of initial vs. recent cases showed trends towards reduced blood loss and WIT.
Conclusions:
- The described hand-assistance timing and placement optimize the retroperitoneoscopic approach.
- This technique enhances surgical ease and safety in live donor nephrectomy.
- No delayed graft function was observed, indicating successful outcomes.
